|Posted by Colorado Massage Therapy on September 12, 2013 at 4:25 PM|
Is Massage Therapy Safe for People Living with Cancer?
Yes, when practiced by a skilled therapist with background or training in massage and cancer. If this was not covered in their basic training in detail, they should have advanced training in the work.
Massage should be modified to work around side-effects or complications of radiation, chemotherapy, surgery, and medications. Blood counts should be considered in massage design, as well. Even after years of survivorship, there are a few simple but critical adjustments in massage therapy, for example, if lymph nodes were removed or treated with radiation, or if bone metastases are present.
Therapists with experience or training are aware of these and other adaptations for cancer treatment. Be sure to see a massage therapist who asks about treatments during the interview and who explains any needed massage modifications.
A skilled therapist will combine a thorough intake process with sound clinical judgement and clear communication about what to expect in the session. She or he will adapt the massage to your needs and requests, fashioning a hands-on session that relaxes, energizes and reduces pain and discomfort.
Can Massage Spread Cancer?
No, it cannot. Massage of a solid tumor site should be avoided, but there is more to a person than a tumor site.
An old myth warned that massage could, by raising general circulation, promote metastasis since tumor cells travel through blood and lymph channels. We now recognize that movement and exercise raise circulation much more than a brief massage can, and that routine increases in circulation occur many times daily in response to metabolic demands of our tissues. In fact, physical activity usually is encouraged in people with cancer; there is no reason to discourage massage or some form of skilled touch. Massage is practiced widely at the Dana-Farber Cancer Institute, Memorial Sloan-Kettering, and growing numbers of hospitals around the country. Metastasis is not a concern; instead, patients and researchers report countless benefits.
How can Massage Benefit People who are Living with Cancer?
Massage has many benefits for people living with cancer. A few are listed, below. We know some of these from clinical observations, some from controlled research, and some from what clients tell us directly.
Massage Reduces Anxiety
Many clients report being less anxious in general when receiving regular massage. In particular, clients in cancer treatment state that massage eases anxiety before and during uncomfortable procedures and interventions. Research literature reports that massage helps anxiety in patients with cancer and in other populations. In repeated studies of various populations, massage helps reduce depression, as well.(1)
Massage Eases Pain
Recipients of massage therapy express less cancer-related pain, treatment-related pain, and pain related to muscle tension. They claim that massage helps “take the edge off” of acute pain and in some cases relieve it entirely. Although the direction of evidence suggests massage is effective for pain relief, (2), (7) more study is needed to firmly establish the role of massage in pain relief for people with cancer.(3)
Massage Helps Control Nausea
Gentle massage has been shown to reduce nausea in inpatients receiving autologous bone marrow transplant. (4)In a pilot nursing study, stimulation of acupressure points has been suggested to reduce nausea in patients in chemotherapy.(5)
A small study suggested that massage helped decrease medical costs of managing nausea and vomiting.(6)
Massage may be a viable, low-cost approach to minimizing this difficult side-effect of medication.
Massage Improves Sleep and Eases Fatigue
Again and again, clients tell their massage therapists that massage improves their energy level and helps them sleep better, and clients in cancer treatment are no exception. But sleep can be especially hard to come by during cancer treatment, and cancer fatigue is common and poorly understood—a difficult symptom to treat. People in treatment, often with a high degree of symptom distress, are especially in need of good sleep. At least one study shows massage facilitates sleep.(7)
As a massage therapist, what do I need to work with people with cancer?
Continuing education training is strongly recommended, preferably with a hands-on component. During their basic massage training, many massage therapists were discouraged from working with people with cancer, and training is needed to move forward with the work.
To work with people with cancer, massage therapists need to know how to work with complex medical conditions: detailed interviewing, recognizing possible massage contraindications and other red flags, researching cancer treatment's effects, applying massage adjustments in massage pressure, joint movement, areas of focus, position, massage lubricant, and when and how to consult the client's physician for needed information. Therapists need to "know what they don't know" and how to fill in gaps in information.
Some therapists may be able to teach themselves how to work safely and effectively with people with cancer, using texts, massage literature, research skills, or on-line courses. Some have medical or nursing training that enables them to sort through clinical presentations and adapt their massage work accordingly.
But most therapists need training that provides skill building in interviewing and clinical thinking, hands-on practice, and supervised clinical work. They need a framework to work within, opportunities to ask "what-if?" questions, to hear clinical scenarios, to use appropriate intake and other forms, and to have materials for further learning at home. Therapists need to be able to adapt to clients with lymphedema, lymphedema risk, bone metastasis, vital organ involvement, risk of deep vein thrombosis, and suppressed blood cell populations. They need to craft an intake and a session for someone with a cancer history, not just with active cancer.
Moreover, therapists need to customize their work to individual client presentations, not offer a one-size-fits-all massage for everyone with cancer. In fact, some people in cancer treatment are active and robust; others are medically frail. A well-prepared therapist recognizes the difference and can adapt to a full range of clinical possibilities. Good training supplies the tools to meet this range in clients and the chance to practice using them, so that one client doesn't receive massage that is too gentle for them, and another too strong.